Provider Demographics
NPI:1124441027
Name:THOMAS, CHRISTOPHER STEPHENS (LMFT)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:STEPHENS
Last Name:THOMAS
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:650 HARBOR ST
Mailing Address - Street 2:#4
Mailing Address - City:VENICE
Mailing Address - State:CA
Mailing Address - Zip Code:90291-4785
Mailing Address - Country:US
Mailing Address - Phone:310-502-4850
Mailing Address - Fax:
Practice Address - Street 1:7461 BEVERLY BLVD
Practice Address - Street 2:SUITE 405
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90036-2704
Practice Address - Country:US
Practice Address - Phone:424-289-0216
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-28
Last Update Date:2014-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA78020106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist